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Thursday, October 30, 2008

Commentary: Virus Spreads as Vermont Legislature Adjourns

A commentary written in Fall 2007 - seemed appropriate:

Early in 2007, in the time it takes most of us to do our Christmas shopping, the Vermont House and Senate introduced separate bills that would require girls enrolled in the 6th grade or higher to receive the human papillomavirus (HPV) immunization. The bills were read, assigned to committees, and then were never heard from again. When the legislature adjourned in May, the HPV bills were left in committee limbo – dying in the State House’s corridors without so much as a whimper. But I whimpered. I screamed. And now I’m fuming.

As an infection that has the ability to conceal itself within the body, HPV is an extremely dangerous sexually transmitted disease (STD). While the body has the ability to fight off some of its 200 varieties, the majority of the time the virus stays hidden until it chooses to reveal itself in the form of genital warts or cervical cancer. It is the latter development that brings HPV to the forefront of medical research, particularly when the government itself reports that 80% of women in the United States will be infected with HPV in their lifetime.

In an effort to decrease the prevalence of infection, the Food and Drug Administration approved Gardasil, a HPV vaccine, for public use in 2006. The vaccine is a quadrivalent HPV immunization that attacks the two strains of the virus, that cause 70% of cervical cancers, with nearly 100% efficiency. It is recommended that the vaccine be administered to girls age 11-12 in a 3-shot schedule; however, few girls are receiving injections and more and more people are getting the STD.Today, 20 million people in the United States are infected with HPV and an additional 6.2 million people will be added to that number by the end of the year. As a direct result of this rate of infection, 9,710 women found out they had cervical cancer in 2006 and 3,700 of them died from the disease that same year. These numbers speak of an unsung epidemic that has left no region untouched, including our own Green Mountain State.

According to the Vermont Department of Health, 31 Vermont women are diagnosed with cervical cancer each year and an average of 10 women die from the disease. These rates are significantly higher than the national average, making it clear that Vermont needs to take preventative measures to ensure the welfare of the states’ population. The number of HPV infections that lead to death is too high when considering the lives that could be saved with a simple vaccine. But clearly the legislature has heard other view points that have discouraged any championship of the bill.

Parents fear that immunizing preteens against a sexually transmitted disease will promote early sexual activity. The idea is that by taking away the fear of receiving a STD there would suddenly be no barrier to prevent teenagers from having sex. However, there has been no evidence to prove that there is a link between a fear of death and abstinence or being vaccinated and having sex. As a matter of fact, immunizing a child against a potentially deadly sexually transmitted infection may one of the most practical things a parent can do considering that over 40% of teenagers have some sort of sexual activity before the age of 18. The Vermont bills even account for the parent’s right to opt out of immunizations on moral or religious grounds, but the opposition still battles on and stays close to the State House.

Without a mandatory status attached to it, the HPV vaccine will have an extremely hard time wiping the illness from the map. If only some children are vaccinated, then the effectiveness of the immunization is greatly reduced because the virus still has unprotected people to act as distribution hubs for the STD. By making the vaccination mandatory it will not only directly protect the 11-12 year olds who are immunized, but also indirectly safeguard the entire population by starting a chain of events that leads to a reduction in the number of cases of cervical cancer and the eventual irradiation of the human papillomavirus.

In addition, a mandatory status for the HPV vaccination eliminates a very real financial barrier for the general population. Each dose of Gardasil costs $120, making the cost for the 3-shot series $360, not including the doctor’s fee. If the vaccine is required by the government, insurance companies then add that vaccination to their coverage and government agencies pay for the uninsured—therefore relieving the financial burden associated with needed but optional inoculations. With the financial barrier destroyed, parents have to face the reality that this vaccination is not just another expense or directive from the government but a real, lifesaving effort. And not just for any life, but that of their child.

One day not too long ago, someone said that it was time to stop polio, measles, and diphtheria from hurting the people of this country—and they did it. Those illnesses are now gone, leaving people with only a fading memory of how things once were. Now HPV stands on that same threshold of destiny, waiting for the day when it will be unknown by the young and only a distant recollection of the old. It is time for the Vermont legislature to champion such a future and take a stance on cervical cancer by passing the HPV vaccine bill. The women of this state want a cancer free future and HPV immunizations are the first, bold step to it.